Predictors of renal function decline in patients with gastroenteropancreatic neuroendocrine tumors undergoing [177Lu]Lu-DOTA-TATE therapy
Abstract Background Peptide receptor radionuclide therapy (PRRT) with [177Lu]Lu-DOTA-TATE is an established treatment for advanced gastroenteropancreatic neuroendocrine tumors (GEP-NETs). While overall renal safety is high, the kidneys remain an organ at risk. This study aimed to determine whether c...
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2025-08-01
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| Series: | EJNMMI Research |
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| Online Access: | https://doi.org/10.1186/s13550-025-01305-8 |
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| author | Felix L. Herr Christian Dascalescu Victoria Fusch Caroline Smith Ricarda Ebner Mathias J. Zacherl Florian Eckenweber Konrad Klimek Christoph J. Auernhammer Christine Spitzweg Jens Ricke Maurice M. Heimer Clemens C. Cyran Rudolf A. Werner Gabriel T. Sheikh |
| author_facet | Felix L. Herr Christian Dascalescu Victoria Fusch Caroline Smith Ricarda Ebner Mathias J. Zacherl Florian Eckenweber Konrad Klimek Christoph J. Auernhammer Christine Spitzweg Jens Ricke Maurice M. Heimer Clemens C. Cyran Rudolf A. Werner Gabriel T. Sheikh |
| author_sort | Felix L. Herr |
| collection | DOAJ |
| description | Abstract Background Peptide receptor radionuclide therapy (PRRT) with [177Lu]Lu-DOTA-TATE is an established treatment for advanced gastroenteropancreatic neuroendocrine tumors (GEP-NETs). While overall renal safety is high, the kidneys remain an organ at risk. This study aimed to determine whether clinical parameters can predict the risk of PRRT-associated renal function decline. Results This retrospective single-center study included 178 patients with well-differentiated GEP-NETs (Grade 1 or 2) who completed four cycles of [177Lu]Lu-DOTA-TATE between 2012 and 2023. Mean baseline eGFR was 81.1 ± 16.3 mL/min/1.73 m² and remained stable at follow-up (81.1 ± 17.8 mL/min/1.73 m², p = 0.989). A KDIGO-defined renal function decline (eGFR follow-up to baseline ratio < 0.8) was observed in 15 patients (8.9%). Higher age at baseline was significantly associated with increased risk (OR: 1.07, 95% CI: 1.01–1.14, p = 0.023), while baseline eGFR (OR: 1.03, 95% CI: 0.99–1.06, p = 0.1) and estimated renal radiation dose (eRRD) (OR: 1.06, 95% CI: 0.89–1.21, p = 0.456) were not significant predictors. No significant associations were found for preexisting renal disease, arterial hypertension, diabetes mellitus, or nephrotoxic drugs. ROC analysis yielded an AUC of 0.683 for age, identifying 68.77 years as the optimal threshold for risk stratification of CKD-progression free survival. Conclusions While the overall risk of renal function decline following [177Lu]Lu-DOTA-TATE therapy of GEP-NET patients is low, age at baseline emerged as a simple yet clinically meaningful predictor of renal function decline in this cohort. |
| format | Article |
| id | doaj-art-4f3e70f7ee9842dd8a4de44456fbbd23 |
| institution | Kabale University |
| issn | 2191-219X |
| language | English |
| publishDate | 2025-08-01 |
| publisher | SpringerOpen |
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| series | EJNMMI Research |
| spelling | doaj-art-4f3e70f7ee9842dd8a4de44456fbbd232025-08-24T11:49:58ZengSpringerOpenEJNMMI Research2191-219X2025-08-011511710.1186/s13550-025-01305-8Predictors of renal function decline in patients with gastroenteropancreatic neuroendocrine tumors undergoing [177Lu]Lu-DOTA-TATE therapyFelix L. Herr0Christian Dascalescu1Victoria Fusch2Caroline Smith3Ricarda Ebner4Mathias J. Zacherl5Florian Eckenweber6Konrad Klimek7Christoph J. Auernhammer8Christine Spitzweg9Jens Ricke10Maurice M. Heimer11Clemens C. Cyran12Rudolf A. Werner13Gabriel T. Sheikh14Department of Radiology, LMU University Hospital, LMU MunichDepartment of Radiology, LMU University Hospital, LMU MunichDepartment of Radiology, LMU University Hospital, LMU MunichDepartment of Radiology, LMU University Hospital, LMU MunichDepartment of Radiology, LMU University Hospital, LMU MunichDepartment of Nuclear Medicine, LMU University Hospital, LMU MunichDepartment of Nuclear Medicine, LMU University Hospital, LMU MunichDepartment of Nuclear Medicine, LMU University Hospital, LMU MunichInterdisciplinary Center of Neuroendocrine Tumors of the GastroEnteroPancreatic System (GEPNET-KUM, ENETS certified Center of Excellence), LMU University Hospital, LMU MunichInterdisciplinary Center of Neuroendocrine Tumors of the GastroEnteroPancreatic System (GEPNET-KUM, ENETS certified Center of Excellence), LMU University Hospital, LMU MunichDepartment of Radiology, LMU University Hospital, LMU MunichDepartment of Radiology, LMU University Hospital, LMU MunichDepartment of Radiology, LMU University Hospital, LMU MunichDepartment of Nuclear Medicine, LMU University Hospital, LMU MunichDepartment of Nuclear Medicine, LMU University Hospital, LMU MunichAbstract Background Peptide receptor radionuclide therapy (PRRT) with [177Lu]Lu-DOTA-TATE is an established treatment for advanced gastroenteropancreatic neuroendocrine tumors (GEP-NETs). While overall renal safety is high, the kidneys remain an organ at risk. This study aimed to determine whether clinical parameters can predict the risk of PRRT-associated renal function decline. Results This retrospective single-center study included 178 patients with well-differentiated GEP-NETs (Grade 1 or 2) who completed four cycles of [177Lu]Lu-DOTA-TATE between 2012 and 2023. Mean baseline eGFR was 81.1 ± 16.3 mL/min/1.73 m² and remained stable at follow-up (81.1 ± 17.8 mL/min/1.73 m², p = 0.989). A KDIGO-defined renal function decline (eGFR follow-up to baseline ratio < 0.8) was observed in 15 patients (8.9%). Higher age at baseline was significantly associated with increased risk (OR: 1.07, 95% CI: 1.01–1.14, p = 0.023), while baseline eGFR (OR: 1.03, 95% CI: 0.99–1.06, p = 0.1) and estimated renal radiation dose (eRRD) (OR: 1.06, 95% CI: 0.89–1.21, p = 0.456) were not significant predictors. No significant associations were found for preexisting renal disease, arterial hypertension, diabetes mellitus, or nephrotoxic drugs. ROC analysis yielded an AUC of 0.683 for age, identifying 68.77 years as the optimal threshold for risk stratification of CKD-progression free survival. Conclusions While the overall risk of renal function decline following [177Lu]Lu-DOTA-TATE therapy of GEP-NET patients is low, age at baseline emerged as a simple yet clinically meaningful predictor of renal function decline in this cohort.https://doi.org/10.1186/s13550-025-01305-8GEP-NET[177Lu]Lu-DOTA-TATEKDIGO 2024Renal toxicityAge |
| spellingShingle | Felix L. Herr Christian Dascalescu Victoria Fusch Caroline Smith Ricarda Ebner Mathias J. Zacherl Florian Eckenweber Konrad Klimek Christoph J. Auernhammer Christine Spitzweg Jens Ricke Maurice M. Heimer Clemens C. Cyran Rudolf A. Werner Gabriel T. Sheikh Predictors of renal function decline in patients with gastroenteropancreatic neuroendocrine tumors undergoing [177Lu]Lu-DOTA-TATE therapy EJNMMI Research GEP-NET [177Lu]Lu-DOTA-TATE KDIGO 2024 Renal toxicity Age |
| title | Predictors of renal function decline in patients with gastroenteropancreatic neuroendocrine tumors undergoing [177Lu]Lu-DOTA-TATE therapy |
| title_full | Predictors of renal function decline in patients with gastroenteropancreatic neuroendocrine tumors undergoing [177Lu]Lu-DOTA-TATE therapy |
| title_fullStr | Predictors of renal function decline in patients with gastroenteropancreatic neuroendocrine tumors undergoing [177Lu]Lu-DOTA-TATE therapy |
| title_full_unstemmed | Predictors of renal function decline in patients with gastroenteropancreatic neuroendocrine tumors undergoing [177Lu]Lu-DOTA-TATE therapy |
| title_short | Predictors of renal function decline in patients with gastroenteropancreatic neuroendocrine tumors undergoing [177Lu]Lu-DOTA-TATE therapy |
| title_sort | predictors of renal function decline in patients with gastroenteropancreatic neuroendocrine tumors undergoing 177lu lu dota tate therapy |
| topic | GEP-NET [177Lu]Lu-DOTA-TATE KDIGO 2024 Renal toxicity Age |
| url | https://doi.org/10.1186/s13550-025-01305-8 |
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